Job Description

This is a remote position.

Our client has an opening for a Provider Engagement Account Manager who is responsible for cultivating and maintaining strong partnerships with contracted healthcare providers within our network. This role focuses on enhancing provider performance, ensuring high-quality care delivery, and optimizing network efficiency through strategic account management. You will serve as the primary point of contact for providers, addressing issues proactively, and driving value-based care initiatives to improve clinical outcomes and cost management.

Location: Atlanta, GA ( Remote with local travel)

Travel : Up to 4 days per week within Georgia (Cobb, Dekalb, Fulton, Gwinnett )

***NOTE: Due to travel requirements, for this role, we are seeking candidates who live in Georgia, specifically Cobb, Dekalb, Fulton, or Gwinnett County***

Position Purpose: Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization.

Key Responsibilities: 

• Build and sustain effective relationships with healthcare providers and act as the main liaison between providers and the health plan.
• Conduct regular in-person visits to physicians and clinical staff to discuss performance metrics, identify opportunities for improvement, and support value-based care initiatives.
• Manage provider performance through data analysis, performance reviews, and strategic planning to meet quality, cost, and utilization goals (HEDIS, HBR, P4Q, etc.).
• Triage provider issues, coordinate responses with internal teams, and ensure timely resolution.
• Drive provider performance improvement initiatives, including risk adjustment, quality measures, and cost/utilization management.
• Support special projects and perform other duties as assigned, ensuring compliance with all policies and standards.
• Utilize data analytics to track provider performance and deliver actionable feedback to optimize care delivery.
• Collaborate with providers on incentive-based models to promote value-based care and patient outcomes.
• Travel locally up to 4 days per week within Georgia.
  

Requirements

• Bachelor’s degree in healthcare, business, or related field; or equivalent experience.
  
• Minimum of two (2) years’ experience in provider engagement, account management, or performance management within a managed care setting .
  
• Proven experience and proficient with provider relations, cost utilization, quality measures (HEDIS), and performance improvement .
  
• Strong project management skills in healthcare environments such as medical groups, IPAs, or health plans .
  
• Proficiency in data analysis related to healthcare quality, cost, and utilization.
  
• Excellent communication, relationship-building, and problem-solving skills.
  
• Account management experience strongly preferred.

Preferred Skills: 

• Experience with value-based care models and incentive programs.
• Knowledge of managed care industry standards and compliance.
  

Benefits

Comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. 

Job Tags

Similar Jobs